JP7178648B1 - Puncture needle holder, Puncture needle attitude setting system - Google Patents

Abstract

An object of the present invention is to correctly determine the posture of a puncture needle before inserting the puncture needle into the body of a subject. SOLUTION: A body portion of a puncture needle holder according to the present disclosure detachably holds a puncture needle and can freely change its posture. The orientation sensor is installed in the main body, defines a cage coordinate system unique to the main body, and detects the orientation of the main body. The reset unit receives a reset input. The relative direction calculation unit detects the relative direction, which is the current direction of the axis of the puncture needle held by the main unit, with reference to the initial coordinate system, which is the retainer coordinate system when the reset is input, by the posture sensor. Calculate based on data. The target input unit receives input of a target direction, which is a target direction of the axis of the puncture needle, with reference to the initial coordinate system. The display data generation unit generates display data that displays a spatial relationship between the calculated relative direction and the target direction whose input is accepted. The display data output unit outputs the generated display data. [Selection drawing] Fig. 8

Description

The present invention relates to a puncture needle holder, a puncture needle orientation system, and a method of using the puncture needle orientation system.

A puncture needle is a medical device that is inserted into the body of a subject such as a patient from the body surface (hereinafter referred to as "body surface" as appropriate). A biopsy needle, which is an instrument for extracting tissue from a target site by inserting it from the body surface of a subject into a target site such as an affected area (for example, cancer tissue) inside the body, is one of them. A puncture needle holder is used to use a puncture needle, and is a device that is placed on the body surface of a subject and holds the puncture needle in a predetermined position and orientation. When using a puncture needle, a doctor or nurse (hereafter referred to as a "doctor, etc.") takes an image of a target site such as an affected area inside the body using a CT scanner, and displays the image on a screen. Determine the position and posture of the puncture needle while looking at it. In order to avoid exposing the hands and fingers of doctors, etc., to the X-rays emitted by the CT scanner, the puncture needle holder is designed to keep the needle in a predetermined posture even when the doctor, etc. releases his/her hand from the needle. It is desired to be a stationary type that holds. At the same time, it is desired that the posture of the puncture needle before insertion can be changed so that the tip of the puncture needle after insertion can appropriately reach a target site such as an affected area.

US Pat. No. 6,200,000, filed by some of the co-applicants of the present application, discloses a puncture needle holder that meets such needs. That is, the puncture needle holder disclosed in Patent Literature 1 enables the posture of the puncture needle to be changed by a finger operation, and fixes the posture of the puncture needle to a desired posture by the same finger operation. making it possible. However, even with the device disclosed in Patent Document 1, the puncture needle and the target site are imaged by a CT scanner before or during the process of advancing the puncture needle toward the target site into the subject's body. , by grasping their positional relationship, it is necessary to confirm whether or not the insertion direction of the puncture needle is correct, and to correct the insertion direction if it is not correct.

Patent No. 6398028

If the posture of the puncture needle can be set in advance so that the puncture needle is correctly aimed at the target site, the inventors of the present application have proposed that the puncture needle be inserted into the subject's body before and during the insertion process. I came to the conclusion that it would be possible to eliminate or reduce the correction of the approach direction, and that it would be unnecessary to adopt a stationary type that holds the puncture needle in a predetermined posture. The present invention has been made in view of the above problems and based on the above ideas, and includes a puncture needle holding device that enables the correct posture of the puncture needle to be set before the needle is inserted into the body of the subject. An object of the present invention is to provide a device, a puncture needle attitude setting system, and a method of using the puncture needle attitude setting system.

To achieve the above object, a first aspect of the present invention provides a puncture needle holder comprising a main body, a posture sensor, a reset section, a relative direction calculator, and a target input section. , a display data generator, and a display data output unit. The main body detachably holds the puncture needle and can freely change its posture. The orientation sensor is installed in the main body, defines a cage coordinate system that is a coordinate system fixed to the main body, and detects the orientation of the main body or a change in the orientation. The reset unit receives a reset input. The relative direction calculation unit calculates the current direction of the axis of the puncture needle held by the main unit based on the initial coordinate system, which is the holder coordinate system when the reset unit receives the reset input. A relative direction is calculated based on the detection data of the attitude sensor. The target input unit receives an input of a target direction, which is a target direction of the axis of the puncture needle, with reference to the initial coordinate system. The display data generation unit generates display data that displays a spatial relationship between the calculated relative direction and the input target direction. The display data output unit outputs the generated display data.

According to this configuration, a user such as a doctor determines the posture of the main body so that the holder coordinate system fixed to the main body matches the CT coordinate system unique to the CT scanning apparatus. The initial coordinate system can be matched with the CT coordinate system by performing calibration by inputting a reset to the reset unit. A relative direction, which is the current direction of the puncture needle with reference to the initial coordinate system, is calculated by the relative direction calculation unit based on the detection data of the posture sensor.
For example, the user specifies the coordinate values in the CT coordinate system of the puncture point on the body surface of the subject and the target site in the body based on the CT scan image of the subject captured by the CT scanning device. , Based on the specified coordinate values, the target direction of the axis of the puncture needle is calculated as a direction based on the CT coordinate system, so that the target based on the initial coordinate system that matches the CT coordinate system Direction can be calculated. By inputting the calculated target direction into the target input unit, the display data generation unit generates data for displaying the spatial relationship between the relative direction and the target direction. The generated display data is output by the display data output section.
The output display data can be displayed on a display screen or the like. A user such as a doctor holds the puncture needle in the main body, positions the main body so that the tip of the puncture needle is positioned at the puncture point, and before the puncture needle enters the body of the subject, the display screen is displayed. Correctly set the posture of the puncture needle so that the held puncture needle aims at the target site by adjusting the posture of the main unit so that the relative direction matches the target direction while viewing the display such as can be done.

According to a second aspect of the present invention, there is provided the puncture needle holder according to the first aspect, wherein the display data generation unit includes, as the display data, a symbol corresponding to the relative direction and a symbol corresponding to the target direction. Data representing the spatial relationship is generated as the positional relationship on the display screen with the symbol to be displayed.

According to this configuration, the user can easily adjust the posture of the puncture needle by visually observing the positional relationship between the symbols displayed on the display screen.

According to a third aspect of the present invention, there is provided the puncture needle holder according to the first or second aspect, wherein the main body portion includes a body portion defining a virtual rotation axis penetrating the body portion; a head adjacent to one end of the trunk along the pivot axis; legs adjacent to the other end of the trunk along the pivot; and a connecting member that connects the head and the leg to each other, and is supported by the body so that the head and the leg are integrated and rotatable about the rotation shaft. is doing. Each of the body, head, and legs has a holding hole for holding the puncture needle at the position of the rotating shaft, and the holding hole extends in the radial direction of the rotating shaft. and guides the puncture needle from the holding hole to the outside of the main body in the radial direction. By setting the rotational positions of the head and the legs with respect to the body so that the guide grooves of the head and the legs are displaced from the positions overlapping the guide grooves of the body , the puncture needle is held in the holding holes of the body, the head, and the leg. By setting the rotational positions of the head and the legs with respect to the body so that the guide grooves of the head and the legs overlap the guide grooves of the body, the puncture is performed. By being guided by the guide grooves that overlap each other, the needles can be taken out of the main body through the holding holes of the body, the head, and the legs.

According to this configuration, after the puncture needle has entered the subject's body, it is possible to remove the body section, which is no longer needed, from the puncture needle.

According to a fourth aspect of the present invention, there is provided a puncture needle holder according to any one of the first to third aspects, comprising a tubular needle holder for holding the inserted puncture needle so as to be able to pass therethrough. , and more. The main body detachably holds the puncture needle by detachably holding the needle holder that holds the puncture needle.

According to this configuration, the sanitary condition of the main body can be maintained by disposing of the needle holder that comes in contact with the puncture needle.

According to a fifth aspect of the present invention, there is provided a puncture needle holder according to any one of the first to fourth aspects, wherein the puncture point on the body surface of the subject detected by a CT scan device Based on the coordinate values in the CT coordinate system, which is a coordinate system unique to the CT scanning device, with the target site, the target direction of the axis of the puncture needle is set as the direction based on the CT coordinate system. A target calculation unit for calculating and inputting the calculated direction to the target input unit as the target direction is further provided.

According to this configuration, the axis of the puncture needle should be targeted based on the coordinate values in the CT coordinate system of the puncture point on the body surface of the subject detected by the CT scanning device and the target site in the body. The direction is automatically calculated and automatically entered as the target direction into the target input section.

A sixth aspect of the present invention is the puncture needle holder according to any one of the first to fourth aspects, wherein the target input unit should allow the puncture needle to enter the body of the subject. It also accepts input of penetration depth, which is depth. Then, the display data generation unit generates, as the display data, data for displaying the approach depth whose input is accepted.

According to this configuration, the user can insert the puncture needle into the subject's body at the correct depth by visually observing the penetration depth displayed as display data on the screen or the like.

According to a seventh aspect of the present invention, there is provided the puncture needle holder according to the sixth aspect, in which a ruler is installed in the main body and has dimensional scales arranged along the puncture needle held by the main body. , and more.

According to this configuration, the user can adjust the depth of penetration of the puncture needle by referring to the scale of the ruler. can be easily done.

According to an eighth aspect of the present invention, there is provided the puncture needle holder according to the sixth or seventh aspect, wherein the puncture point on the body surface of the subject and the target site in the body detected by a CT scanner are detected. and calculating a target direction of the axis of the puncture needle as a direction based on the CT coordinate system based on the coordinate values in the CT coordinate system, which is a coordinate system unique to the CT scanning device, a target calculation unit for inputting the calculated direction into the target input unit as the target direction, calculating the approach depth, and inputting the calculated approach depth to the target input unit; there is

According to this configuration, the axis of the puncture needle should be targeted based on the coordinate values in the CT coordinate system of the puncture point on the body surface of the subject detected by the CT scanning device and the target site in the body. The direction is automatically calculated and automatically input as the target direction into the target input section, and the penetration depth is automatically calculated and automatically input into the target input section.

A ninth aspect of the present invention is the puncture needle holder according to any one of the first to eighth aspects, further comprising: a display screen for displaying the display data output by the display data output unit; I have.

According to this configuration, the user can set the posture of the puncture needle correctly or allow the puncture needle to enter the subject's body at the correct depth while viewing the display data displayed on the display screen. .

A tenth aspect of the present invention is a puncture needle orientation system comprising a CT scanning device and a puncture needle holder according to the ninth aspect.

According to this configuration, the user, while viewing the display data displayed on the display screen of the puncture needle holder, can determine whether the relative direction of the axis of the puncture needle is correct before inserting the puncture needle into the body of the subject. By adjusting the posture of the body to match the target direction, the posture of the puncture needle held by the body can be set correctly so that the needle is aimed at the target site.

According to an eleventh aspect of the present invention, there is provided a method of using the puncture needle attitude setting system according to the tenth aspect, comprising: (a) fixing the puncture needle holder included in the puncture needle attitude setting system to the body portion; The posture of the main body is determined so that the holder coordinate system set as the coordinate system configured as the coordinate system matches the CT coordinate system unique to the CT scanning device provided in the puncture needle posture setting system, and the puncture needle (b) capturing a CT scan image of the subject by the CT scanning device included in the puncture needle posture setting system; (c) capturing the captured image; (d) specifying coordinate values in the CT coordinate system of the puncture point on the body surface of the subject and a target site in the body based on the CT scan image; and (d) based on the specified coordinate values. Then, the target direction of the puncture needle axis is calculated as a direction based on the CT coordinate system, and the calculated direction is input to the target input unit of the puncture needle holder as the target direction. inputting or inputting the specified coordinate values to the target calculation unit of the puncture needle holder; (e) causing the body portion of the puncture needle holder to hold the puncture needle; f) determining the position of the main body that holds the puncture needle so that the tip of the puncture needle is positioned at the puncture point; determining the relative direction to match the target direction based on display data displayed on the display screen of the puncture needle holder.

According to this configuration, the posture of the puncture needle is correctly set so that the held puncture needle aims at the target site before the puncture needle enters the subject's body. The steps (a) to (g) can be performed in any order as long as the steps described above are not presupposed.

As described above, according to the present invention, a puncture needle holder, a puncture needle attitude setting system, and a puncture needle attitude that make it possible to set the attitude of the puncture needle correctly before the puncture needle enters the body of the subject. The usage of the configuration system is realized.

1 is a schematic perspective view illustrating the appearance of a puncture needle orientation setting system according to an embodiment of the present invention; FIG. 1 is a schematic perspective view illustrating the appearance of a puncture needle holder according to one embodiment of the present invention; FIG. Fig. 3 is an exploded perspective view of the body portion of the puncture needle holder of Fig. 2; 3A is a plan view, FIG. 4B is an end view of a cut portion along the line AA, and FIG. It is a sectional view along a cutting line. Fig. 3 is a perspective view illustrating a method of using the main body of the puncture needle holder of Fig. 2, where (a) is the state before the needle holder is attached, (b) is the process of attaching the needle holder, and (c) ) illustrates the operation after mounting the needle holder. 3A is a plan view, (b) is a front view, and (c) is a side view. c) particularly illustrates the state in which the needle holder holds the puncture needle. 3 is a block diagram illustrating the basic hardware configuration of a computer included in the puncture needle holder of FIG. 2; FIG. FIG. 3 is a block diagram illustrating a functionally based configuration of the puncture needle holder of FIG. 2; 2 is a flow chart illustrating a method of using the needle orientation system of FIG. 1; 3 is a perspective view illustrating a pedestal used for calibrating a coordinate system unique to the main body of the puncture needle holder of FIG. 2; FIG. 3A is a schematic diagram illustrating a place where a main body is placed for calibration of a coordinate system of the main body of the puncture needle holder of FIG. 2, (a) being a front view, and (b) being a plan view; FIG. 3 is a diagram showing an example in which coordinate axes X and Y of a holder coordinate system, which is a coordinate system specific to the main body of the puncture needle holder of FIG. 2, are displayed on the top of the head of the main body. FIG. FIG. 2 is an explanatory diagram illustrating the relationship between a CT coordinate system, which is a coordinate system unique to a CT scanner, and a holder coordinate system in the puncture needle orientation setting system of FIG. 1; 3 is a screen diagram illustrating an image displayed on the display screen of the puncture needle holder of FIG. 2; FIG. FIG. 10 is a perspective view illustrating the configuration of the main body of the puncture needle holder according to another embodiment of the present invention; 16 is a perspective view illustrating how to use the main body of FIG. 15; FIG. FIG. 11 is a perspective view illustrating the configuration of the main body of the puncture needle holder according to still another embodiment of the present invention;

FIG. 1 is a schematic perspective view illustrating the appearance of a puncture needle attitude setting system according to one embodiment of the present invention. This puncture needle posture setting system 101 has a CT scan device 102 and a puncture needle holder 103 . The CT scan apparatus 102 is, for example, a commercially available well-known apparatus, and has a scan gantry 1 , a bed 3 , a bed drive table 5 and an operation panel 7 . A subject 10 , such as a patient, lies on the bed 3 , and the bed 3 is driven by the bed drive table 5 to carry the subject 10 into and out of the cavity of the scan gantry 1 . In the process, an X-ray tomogram of the subject 10 is taken by the X-ray source and X-ray detector built in the scan gantry 1 . The scan gantry 1 and the bed drive table 5 are operated by operating an operation panel 7 by an operator such as a doctor. Also, the captured X-ray tomogram is displayed on the display screen of the operation panel 7 .

The puncture needle holder 103 has a puncture needle holder main body portion (hereinafter referred to as “main body portion”) 11 and a puncture needle holder attachment portion (hereinafter referred to as “attachment portion”) 13 . The body portion 11 is a device portion that detachably holds the puncture needle 15, and is held on the body surface of the subject 10 so that the posture can be freely changed by the hand of a user such as a doctor. used. A posture sensor (not shown) for detecting the posture of the body portion 11 or a change in the posture is installed in the body portion 11 . The attachment part 13 is a device part that shares the function of the puncture needle holder 103 with the main body part 11, and is placed on the bed 3 and used, for example. As an example, the attachment unit 13 incorporates a computer (not shown) that performs a function of processing detection data of the posture sensor, has an operation unit (not shown) such as buttons and dials that accept user operations, and has a puncture needle. It has a display screen that displays the spatial relationship between the 15 target poses and the current pose. The orientation sensor installed in the main unit 11 and the computer installed in the accessory unit 13 exchange data with each other, for example, by short-range wireless communication.

FIG. 2 is a schematic perspective view illustrating the appearance of puncture needle holder 103 in more detail. The main body 11 has a tubular trunk 17 , a head 19 installed above the trunk 17 , and legs 21 installed below the trunk 17 . A tubular needle holder 23 for holding the puncture needle 15 so as to be able to pass therethrough is detachably attached to the central portion of these. In this manner, the body portion 11 of the illustrated example detachably holds the puncture needle 15 together with the needle holder 23 .

The attachment part 13 has operation buttons 27 , 29 , 31 and operation dials 33 , 35 , 37 so as to be exposed to the outside of a housing (cabinet) 25 . Further, the display screen 39 is arranged so as to be exposed through an opening provided on the front surface of the housing 25 . As an example, the operation button 27 is an operation button for turning on/off the power. A cage coordinate system XYZ, which is a coordinate system fixed to the body portion 11, is determined by an orientation sensor (not shown) installed in the body portion 11. FIG. The operation buttons 29 and 31 are operation buttons for storing the retainer coordinate system XYZ in the posture when the button is pressed as the initial coordinate system. As an example, the operation button 29 stores the initial directions of the X and Y coordinate axes of the retainer coordinate system XYZ, and the operation button 31 stores the initial direction of the Z coordinate axis. Thus, the operation buttons 29 and 31 are operation buttons for resetting the retainer coordinate system XYZ in the initial posture, that is, the initial coordinate system. Operation buttons 29 and 31 are used to calibrate the initial coordinate system to match the coordinate system xyz unique to CT scanner 102 .

The operation dials 33 and 35 are operation dials for inputting a target direction, which is a target direction of the axis of the puncture needle 15 with reference to the initial coordinate system. As an example, the operation dial 33 sets the rotation angle around the Y-axis of the target direction with the X-axis of the initial coordinate system as the starting point, and the operation dial 35 sets the rotation angle of the target direction with the Y-axis of the initial coordinate system as the starting point. Used to set the rotation angle around the axis. The operation dial 37 is an operation dial used for enlarging or reducing an image displayed on the display screen 39 .

3 is an exploded perspective view of the main body 11. FIG. 4A and 4B are diagrams illustrating the structure of the main body 11, where (a) is a plan view, (b) is an end view of a cut section along the AA section line, and (c) is a BB section. FIG. 4 is a cross-sectional view along a line; The trunk portion 17 is, for example, cylindrical, and defines a virtual rotation axis 41 along its central axis. The head 19 is disc-shaped as an example, and is arranged adjacent to one end of the body 17 along the rotation shaft 41 . The leg portion 21 has an inverted truncated cone shape, for example, and is arranged adjacent to the other end of the trunk portion 17 along the rotation shaft 41 . In the illustrated example, the body portion 17 is configured by two members fixed to each other, and the leg portion 21 is similarly configured by fixing two members to each other. The body portion 11 further has a semi-cylindrical connecting member 43 passing through the trunk portion 17 along the rotation shaft 41 , and the head portion 19 and the leg portion 21 are immovably connected to each other by the connecting member 43 . It is The connecting member 43 is supported by the body portion 17 so as to be freely rotatable around the rotating shaft 41 integrally with the head portion 19 and the leg portion 21 .

Each of the body portion 17 , the head portion 19 and the leg portion 21 has a holding hole 45 for holding the puncture needle 15 together with the needle holder 23 (see FIG. 2) at the position of the rotation shaft 41 . An axial direction 91 of the held puncture needle 15 coincides with the direction of the rotation shaft 41 . In the illustrated example, a connecting member 43 is supported in the central portion of the trunk portion 17 , and the holding hole 45 of the trunk portion 17 is directly formed by the connecting member 43 . Body portion 17 , head portion 19 , and leg portion 21 further communicate with holding hole 45 in the radial direction of rotating shaft 41 , thereby moving needle holder 23 and puncture needle 15 from holding hole 45 to main body. It has a guide groove 47 that guides it radially to the outside of the portion 11 .

As an example, the body portion 17 is hollow having a cavity 49 inside, and electronic components such as a circuit board 51 , a posture sensor 53 , a wireless communication interface 55 and a power supply battery 57 are arranged in the cavity 49 . The circuit board 51 is supported by a support rod 50 extending downward from the head 19 through a hole formed in the top of the body 17. Other electronic components such as the posture sensor 53 are mounted on the circuit board. 51 is located. Therefore, these electronic components rotate together with the head portion 19 and the leg portion 21 with respect to the body portion 17 . The arrangement of electronic components in the illustrated example is merely an example, and electronic components can be arranged in various ways.

5A and 5B are perspective views illustrating how to use the main body 11, in which (a) is the state before the needle holder 23 is attached, (b) is the process of attaching the needle holder 23, and (c). 4 exemplifies the operation after the needle holder 23 is attached. 6A and 6B are diagrams illustrating a state in which the needle holder 23 is attached to the main body 11, where (a) is a plan view, (b) is a front view, (c) is a side view, and (c). particularly shows the state in which the needle holder 23 holds the puncture needle 15 .
By setting the rotational positions of the head and leg portions 21 with respect to the body portion 17 so that the guide grooves 47 of the head portion 19 and the leg portions 21 respectively overlap the guide grooves 47 of the body portion 17 ( 5(a)), the needle holder 23 is guided by the guide grooves 47 overlapping each other, so that the needle holder 23 can be mounted in the holding hole 45 from the outside in the radial direction of the main body 11 (FIG. 5(b)). ), see FIG. 6). After that, the head portion 19 and the leg portion 21 are turned to the rotational positions with respect to the body portion 17 so that the guide grooves 47 of the head portion 19 and the leg portions 21 are displaced from the positions overlapping the guide grooves 47 of the body portion 17 . (see FIG. 5(c)), the needle holder 23 loses its escape route and is held in the holding holes 45 of the trunk 17, head 19 and leg 21. As shown in FIG. Thereafter, the rotational positions of the head portion 19 and the leg portion 21 are set with respect to the body portion 17 so that the guide grooves 47 of the head portion 19 and the leg portions 21 overlap the guide grooves 47 of the body portion 17 again. As a result, the needle holders 23 are guided by the guide grooves 47 overlapping each other, so that the needle holders 23 can be taken out radially outward of the main body 11 through the holding holes 45 .

In this manner, the body portion 11 can attach and detach the puncture needle 15 along the radial direction together with the needle holder 23 . Therefore, after inserting the puncture needle 15 into the body of the subject 10 , the body part 11 that is no longer needed can be removed from the puncture needle 15 and the needle holder 23 .

FIG. 7 is a block diagram illustrating a schematic configuration of a computer that puncture needle holder 103 has. The illustrated computer 160 has a central processing unit (CPU) 161 , a memory (ie, storage medium) 163 and an input/output interface 165 . The CPU 161 operates based on a program stored in the memory 163 to perform processing such as calculating the current axial direction 91 of the puncture needle 15 based on the initial coordinate system based on the detection data of the attitude sensor 53 . I do. The CPU 161 exchanges signals with external devices of the computer 160 such as the attitude sensor 53 , the operation buttons 29 and 31 , the operation dials 33 , 35 and 37 and the display screen 39 through the input/output interface 165 .

FIG. 8 is a block diagram illustrating a functional configuration of the puncture needle holder 103. As shown in FIG. The calculation unit 59 is implemented by a computer 160 (see FIG. 7). The computer 160 is installed in the attachment part 13 as an example. In this case, the function of the computing section 59 is performed by the attached section 13 . By sharing the functions of the puncture needle holder 103 between the main body 11 and the attached part 13 in this way, the weight of the main body 11 can be reduced, and the operability of the main body 11 can be improved. In general, the function of puncture needle holder 103 can be shared in various ways between body portion 11 and attachment portion 13 . For example, the computer 160 can be separately installed in both the main unit 11 and the attachment unit 13, and the functions of the calculation unit 59 can be shared by both. Moreover, it is also possible for the main body part 11 to perform all the functions of the puncture needle holder 103 . In this case, the attachment part 13 becomes useless. In the form in which the main body part 11 and the attached part 13 share the function of the puncture needle holder 103, data communication between the main body part 11 and the attached part 13 is performed by, for example, the wireless communication interface 55 (see FIG. This is possible by installing both the part 11 and the attachment part 13 .

The calculation unit 59 has a reset unit 61 , a relative direction calculation unit 63 , a target input unit 65 , a display data generation unit 67 and a display data output unit 69 . The reset unit 61 receives a reset input from the operation buttons 29 and 31 . The relative direction calculation unit 63 calculates the current direction of the axis of the puncture needle 15 held by the body unit 11 with reference to the initial coordinate system XYZ, which is the holder coordinate system XYZ when the reset unit 61 receives the reset input. is calculated based on the detection data of the attitude sensor 53 . The target input unit 65 receives an input of a target direction, which is a target direction of the axis of the puncture needle 15 with reference to the initial coordinate system XYZ. Input of the target direction is performed by operating the operation dials 33 and 35, for example. The display data generation unit 67 generates display data that displays the spatial relationship between the calculated relative direction and the target direction whose input is accepted. The display data output unit 69 outputs the generated display data to the display screen 39 .

As exemplified by the dotted line frame in FIG. The target calculation unit 71 calculates the axis of the puncture needle 15 based on the coordinate values in the CT coordinate system xyz of the puncture point on the body surface of the subject 10 detected by the CT scanning device 102 and the target site in the body. A target direction is calculated as a direction based on the CT coordinate system xyz, and the calculated direction is input to the target input unit 65 as the target direction. A “puncture point” means a position on the body surface of the subject 10 into which the puncture needle 15 should be inserted. If the target calculator 71 is provided, the target direction is automatically calculated based on the coordinate data detected by the CT scanning device 102 . In this case, the operation dials 33 and 35 may be omitted. The coordinate data detected by the CT scanning device 102 may be manually input to the target calculation unit 71 or may be automatically input from the operation panel 7 of the CT scanning device 102 . In the latter case, wired or wireless data communication is performed between the operation panel 7 and the puncture needle holder 103 (for example, the attachment 13).

FIG. 9 is a flowchart illustrating a method of using the puncture needle orientation setting system 101. As shown in FIG. When this method of use is started, the coordinate system is first calibrated (step S1). The coordinate system is calibrated so that the holder coordinate system XYZ, which is set as the coordinate system fixed to the main body 11 of the puncture needle holder 103, matches the CT coordinate system xyz unique to the CT scan device 102. By determining the attitude of the unit 11 and pressing the operation buttons 29 and 31 , reset can be input to the reset unit 61 of the puncture needle holder 103 . By this calibration, the initial coordinate axes X, Y, and Z of the cage coordinate system XYZ, that is, the coordinate axes X, Y, and Z of the initial coordinate system XYZ are determined to match the coordinate axes x, y, and z of the CT coordinate system xyz. be done.

Next, a CT scan image of the subject 10 is taken by operating the CT scanning device 102 (step S2). When the imaging is performed, the captured CT scan image is displayed on the display screen of the operation panel 7 (see FIG. 1).

Next, based on the CT scan image displayed on the display screen, the coordinate values in the CT coordinate system xyz of the puncture point on the body surface of the subject 10 and the target site inside the body are specified (step S3). This operation can be performed by the operator of the CT scanning device 102 by viewing the CT scan image displayed on the display screen.

Next, based on the identified coordinate values, a target direction of the axis of the puncture needle 15 is calculated as a direction with the CT coordinate system xyz as a reference (step S4). Subsequently, the calculated direction is input as the target direction to the target input unit 65 of the puncture needle holder 103 (step S5). The target direction can be input by operating the operation dials 33 and 35, for example. If the calculation unit 59 has a target calculation unit 71, instead of the operations in steps S4 and S5, the coordinate values specified in step S3 are input to the target calculation unit 71 using an input device such as a keyboard. can be entered. Through steps S4 and S5, the display screen 39 of the puncture needle holder 103 displays the spatial relationship between the relative direction calculated by the relative direction calculator 63 and the target direction whose input is received by the target input unit 65. Display data to be displayed.

Next, the puncture needle 15 is held in the body portion 11 of the puncture needle holder 103 (step S6). This operation can be performed by inserting the puncture needle 15 through the insertion hole of the needle holder 23 held in the main body 11, as illustrated in FIG. 6(c). The inserted puncture needle 15 stops at an arbitrary position in the insertion hole due to, for example, friction. As exemplified in FIG. 6(c), it is desirable to hold the puncture needle 15 at a position where the tip thereof is somewhat exposed from the bottom of the needle holder 23. As shown in FIG.

Next, the body portion 11 holding the puncture needle 15 is positioned so that the tip of the puncture needle 15 is positioned at the puncture point (step S7). The puncture point can be clearly indicated by attaching a marker on the body surface of the subject 10 in advance. If the marker contains, for example, metal, the marker will also appear on the CT scan image, making it easier to specify the position of the puncture point on the CT scan image in step S3.

Next, based on the display data displayed on the display screen 39 of the puncture needle holder 103, the posture of the main body 11 holding the puncture needle 15 is determined so that the relative direction matches the target direction (step S8). . By the above operation, the posture of the puncture needle 15 is correctly set so that the held puncture needle 15 aims at the target site before the puncture needle 15 is inserted into the body of the subject 10 .

FIG. 10 is a perspective view illustrating a pedestal used for calibrating holder coordinate system XYZ, which is a coordinate system unique to main body 11 of puncture needle holder 103 . The pedestal 73 holds the main body 11 so that the Z-axis direction of the cage coordinate system XYZ is vertical when placed on a horizontal table. In the illustrated example, the direction of the rotation shaft 41 of the main body 11, that is, the axial direction 91 of the held puncture needle 15 is set in the Z-axis direction of the holder coordinate system XYZ. The calibration is performed so that the coordinate axes X, Y, Z of the cage coordinate system XYZ coincide with the coordinate axes x, y, z of the CT coordinate system xyz.

11A and 11B are schematic diagrams illustrating locations where the main body 11 is placed for calibration of the cage coordinate system XYZ, where (a) is a front view and (b) is a plan view. FIG. 12 is a diagram showing an example in which the coordinate axes X and Y of the retainer coordinate system XYZ are displayed on the top surface of the main body 11. As shown in FIG. In the illustrated example, the calibration is performed in two stages, that is, the calibration of the X and Y coordinate axes and the calibration of the Z coordinate axis.

The coordinate axes X and Y are calibrated using the function of projecting a light beam (light beam) 75 of the CT scanning device 102 . The light ray 75 is projected in the directions of coordinate axes x and y of the CT coordinate system xyz. As illustrated in FIGS. 11A and 11B, a pedestal 73 for holding the main body 11 is placed on the bed 3, and the coordinate axes x and y indicated by the light beam 75 projected from the scan gantry 1 are arranged. The direction of the body portion 11 is determined so that the coordinate axes X and Y of the retainer coordinate system XYZ coincide with the direction. In the illustrated example, the coordinate axis x is a coordinate axis set in the right and left direction of the subject 10, and is called "Right-Left" in this field. A coordinate axis y is a coordinate axis set in the direction of the body axis of the subject 10, and is called "Cranial-Caudal" in this field.
As illustrated in FIG. 12, the directions of the coordinate axes X and Y are engraved on the top surface of the head 19 of the main body 11 . The direction of the main body 11 is determined so that the engraved coordinate axes X, Y coincide with the coordinate axes x, y. Since the cushion material is arranged on the surface of the bed 3, the posture of the base 73 may vary slightly, but the influence on the directions of the coordinate axes X and Y can be ignored. By pressing the operation button 29 (see FIGS. 2 and 8) in a state in which the direction of the main unit 11 is determined so that the coordinate axes X and Y coincide with the coordinate axes x and y, the coordinate axes X and Y at this time point can be adjusted. are stored in the relative direction calculator 63 (see FIG. 8) as coordinate axes X and Y of the initial coordinate system XYZ.

The coordinate axis Z is calibrated by placing the pedestal 73 holding the main body 11 on the top surface 81 of the table 79 placed on the floor 77 on the premise that the CT scanning apparatus 102 is installed on the horizontal floor 77 . This is done by placing The base 79 is made so that the top surface 81 is also horizontal when placed on the horizontal floor surface 77 . If a commercially available table can be placed on the horizontal floor surface 77 and it can be confirmed with a spirit level that the top surface 81 is sufficiently horizontal, this table can be used as the table 79. . When the pedestal 73 holding the body portion 11 is placed on the top surface 81, the coordinate axis Z of the retainer coordinate system XYZ is vertical. By pressing the operation button 31 (see FIGS. 2 and 8) in this state, the coordinate axis Z at this point is stored in the relative direction calculator 63 (see FIG. 8) as the coordinate axis Z of the initial coordinate system XYZ. be.

For example, a commercially available 9-axis sensor can be used as the orientation sensor 53 . A 9-axis sensor detects three-axis components of acceleration, angular velocity, and geomagnetism (that is, each coordinate axis component of a coordinate system unique to the sensor). When the orientation sensor 53 has an acceleration sensor, such as when the orientation sensor 53 is a 9-axis sensor, detection data of the orientation sensor 53 can be used to calibrate the Z coordinate axis. That is, by pressing the operation button 31 in a state in which the main body 11 is held so that the coordinate axis Z of the retainer coordinate system XYZ coincides with the direction of the gravitational acceleration detected by the attitude sensor 53, the coordinate axis Z in the vertical direction is adjusted. , is stored in the relative direction calculator 63 (see FIG. 8) as the coordinate axis Z of the initial coordinate system XYZ.

FIG. 13 is an explanatory diagram illustrating the relationship between the CT coordinate system xyz and the retainer coordinate system XYZ. The retainer coordinate system XYZ calibrated to match the CT coordinate system xyz is arranged so that the tip of the puncture needle 15 held by the body part 11 coincides with the puncture point 83 on the body surface of the subject 10. When the part 11 is moved, it generally assumes a posture inclined from the CT coordinate system xyz, as shown in the illustrated example. As an example, an annular marker 85 surrounding the puncture point 83 is attached on the body surface of the subject 10 to clearly indicate the position of the puncture point 83 . A doctor or the like who operates the body portion 11 can know the puncture point 83 by using the marker 85 as a mark. If the material of the marker 85 contains metal, it becomes easier to specify the puncture point 83 in the CT scan image.

A target direction 89 from the puncture point 83 to a target site 87 inside the body of the subject 10 is constant with respect to the CT coordinate system xyz. As already mentioned, the target direction 89 can be set, for example, by operating the operation dials 33, 35 (see FIG. 2). As an example, an axial direction 91 of the puncture needle 15 defined in the direction of the coordinate axis Z of the holder coordinate system XYZ changes along with the attitude of the body portion 11 . By selecting the posture of the main body 11 so that the axial direction 91 of the puncture needle 15 coincides with the target direction 89 , the axial direction 91 of the puncture needle 15 can be set in the correct direction aiming at the target site 87 . The distance from the puncture point 83 to the target site 87 is the penetration depth 90 to which the puncture needle 15 should enter.

FIG. 14 is a screen diagram illustrating an image displayed on the display screen 39 of the puncture needle holder 103. As shown in FIG. In the illustrated image, coordinate axes X and Y of an initial coordinate system XYZ, which is the retainer coordinate system XYZ at the time of calibration, are displayed. The initial coordinate system XYZ coincides with the CT coordinate system xyz by calibration. A target direction 89 is displayed at the intersection of the displayed coordinate axes X, Y, that is, the origin, and an axial direction 91 of the puncture needle 15, which is the direction of the coordinate axis Z of the current holder coordinate system XYZ, is displayed on the coordinate axes X, Y. be done. In the display of the axial direction 91, in order to match the axial direction 91 with the target direction 89, the body portion 11 is rotated around the coordinate axis Y at an angle represented by the coordinate value of the axial direction 91 on the coordinate axis X, It means that the main body 11 should be rotated around the coordinate axis X by the angle represented by the coordinate value of the axial direction 91 on the coordinate axis Y. That is, the coordinate values of the axial direction 91 on the coordinate axes X, Y indicate the difference from the target direction 89 represented by the angle of rotation about the coordinate axes X, Y. FIG.

A doctor or the like who operates the main unit 11 aligns the main unit 11 with the coordinate axes X, Y of the initial coordinate system XYZ (CT coordinate system xyz ), the axial direction 91 can be easily aligned with the target direction 89 . In the illustrated example, a circle representing an accuracy tolerance 93 is displayed around the target direction 89 on the image. If the axial direction 91 is within the allowable range 93, the axial direction 91 matches the target direction 89 with sufficiently high accuracy. For example, by operating the operation dial 37 (see FIG. 2), it is possible to enlarge or reduce the displayed image. When the axial direction 91 approaches the target direction 89 or the allowable range 93, the axial direction 91 can be brought closer to the target direction 89 or the allowable range 93 more easily by enlarging the displayed image. Note that the coordinate axes X and Y displayed on the display screen 39 may be opposite to each other. That is, it may be displayed such that the coordinate axis X extends in the vertical direction and the coordinate axis Y extends in the horizontal direction.

In the illustrated image, digital numbers are also displayed at the same time. That is, in the lower part of the display screen 39, the target direction 89 is digitally displayed on the left side, and the axial direction 91 is digitally displayed on the right side. In the illustrated example, the target direction 89 represents that the coordinate axis X is rotated about the coordinate axis Y by +10° based on the initial coordinate system XYZ, and the coordinate axis Y is rotated about the coordinate axis X by +20°. . On the other hand, the axial direction 91 is the direction in which the coordinate axis X is rotated +9.0° around the coordinate axis Y based on the initial coordinate system XYZ, and the coordinate axis Y is rotated around the coordinate axis X by -19.5°. represents something. The difference in those angles is displayed in analog form at the top of the display screen 39 . A doctor or the like can accurately grasp the difference in angle between the axial direction 91 and the target direction 89 by viewing the digital display.

FIG. 15 is a perspective view illustrating the configuration of the main body of the puncture needle holder according to another embodiment of the present invention. In the puncture needle holder 104 , a ruler 94 with dimensional scales arranged along the axial direction 91 of the puncture needle 15 is installed on the body portion 11 . In the illustrated example, the ruler 94 is erected on the head portion 19 of the body portion 11 so as to extend upward from the head portion 19 .

In addition to the target direction 89, the distance between the puncture point 83 and the target site 87, that is, the penetration depth 90 (see FIG. 13) of the puncture needle 15 is also input to the target input unit 65 (see FIG. 8). It is possible to In this case, the display data output unit 69 (see FIG. 8) can also display the approach depth 90 whose input is received by the target input unit 65 as display data to be displayed on the display screen 39 . A doctor or the like can adjust the penetration depth of the puncture needle 15 while referring to the displayed penetration depth 90, thereby allowing the tip of the puncture needle 15 to reach the target site 87 accurately. . The ruler 94 can be used to adjust the depth of penetration of the puncture needle 15 . That is, by referring to the dimensional scale attached to the ruler 94, the depth of penetration of the puncture needle 15 can be adjusted with high accuracy.

When the calculation unit 59 (FIG. 8) has a target calculation unit 71, the target calculation unit 71 calculates the puncture point 83 on the body surface of the subject 10 detected by the CT scan device 102 and the target site 87 in the body. Based on the coordinate values in the CT coordinate system xyz, the target direction 89 and the penetration depth 90 can be calculated, and the calculated data can be input to the target input unit 65 . That is, the target direction 89 and the approach depth 90 are automatically calculated from the coordinate values in the CT coordinate system xyz, and the data are input to the target input section.

16 is a perspective view illustrating how to use the body portion 11 illustrated in FIG. 15. FIG. To use the body portion 11 with the ruler 94 , for example, the puncture needle 15 is held in the body portion 11 with the marker 97 attached to the upper portion of the puncture needle 15 . At this time, the marker 97 is exposed above the head portion 19 of the body portion 11 . Next, the scale of the ruler 94 corresponding to the penetration depth 90 is read, and the marker 97 is moved to the portion of the puncture needle 15 that matches this scale using, for example, tweezers. Next, by pushing the puncture needle 15 into the main body 11 until the marker 97 comes into contact with the head 19 or until the marker 97 matches the scale value “0” of the ruler 94, the puncture needle 15 is displayed on the display screen. It can be penetrated to a depth corresponding to the penetration depth 90 indicated at 39 .
In the illustrated example, the marker 97 is an elastic body such as rubber having a through hole. A puncture needle 15 is inserted through a through hole formed along the central axis of the cylindrical elastic body. The marker 97 can be held at an arbitrary position on the puncture needle 15 by the frictional force of the elastic restoring force of the elastic body, and can be shifted by applying an appropriate force. If a slit communicating with the through-hole is formed in the cylindrical elastic body in one radial direction, the marker 97 can be attached to the puncture needle 15 after the puncture needle 15 is held in the main body 11. . As the marker 97, a small clip that can open and close the puncture needle 15 by elastic force can be used.

FIG. 17 is a perspective view illustrating the configuration of the main body of the puncture needle holder according to still another embodiment of the present invention. 2 to 5 are of a type that is always held and operated by a doctor or the like, whereas the main body 211 illustrated in FIG. It is a stationary type that holds the puncture needle 15 in a predetermined posture even if it is released. In this way, the puncture needle holder of the present invention can also take the form of a stationary type.

A body portion 211 illustrated in FIG. 17 has a pedestal 201 , a needle insertion tube 207 , a pair of support members 203 and 205 and a screw body 209 . The pedestal 201 is placed on the body surface of the subject 10 and has an opening 221 that rotatably supports the bottom of the needle insertion tube 207 . The needle insertion tube 207 holds a needle holder 253 through which the puncture needle 15 is inserted. Like the needle holder 23 (see FIG. 5), the needle holder 253 is discarded each time the puncture needle 15 is used. Support members 203 and 205 are each curved in a semicircular shape, and both ends thereof are rotatably supported on base 201 so as to intersect with each other, and needle insertion tube 207 is slidable in both circumferential directions. Support at both intersections for movement. The threaded body 209 is screwed into the needle insertion tube 207 at the radially outer side of the intersection. and the needle insertion tube 207 are fastened. The body part 211 in the illustrated example cannot be removed from the puncture needle 15 while the puncture needle 15 is inserted into the body of the subject 10, unlike the body part 11 (see FIG. 3, etc.). However, since the body part 211 is of a stationary type, it is not necessary to remove the puncture needle 15 from the puncture needle 15 while the puncture needle 15 remains inserted into the body of the subject 10 .

An electronic component case 213 is installed in the needle insertion tube 207 . Electronic components such as the circuit board 51, the attitude sensor 53, the wireless communication interface 55, and the power supply battery 57 illustrated in FIG. 4 are arranged in the electronic component case 213 (not shown). Therefore, these electronic parts tilt together with the needle insertion tube 207 . As illustrated in FIG. 12, coordinate axes X and Y of the cage coordinate system XYZ are displayed on the upper surface of the electronic component case 213 (not shown). The direction of gravitational acceleration detected by the attitude sensor 53 can be used to calibrate the coordinate axis Z of the retainer coordinate system XYZ. In the body portion 211 as well, the axial direction 91 of the puncture needle 15 is set in the direction of the coordinate axis Z of the holder coordinate system XYZ.

1 scan gantry 3 bed 5 bed driving table 7 operation panel 10 subject 11 main body 13 appendage 15 puncture needle 17 body 19 head 21 leg 23 needle holder 25 Case 27,29,31 Operation Button 33,35,37 Operation Dial 39 Display Screen 41 Rotating Axis 43 Connecting Member 45 Holding Hole 47 Guide Groove 49 Cavity 50 Support Rod 51 Circuit board 53 Attitude sensor 55 Wireless communication interface 57 Power battery 59 Calculation unit 61 Reset unit 63 Relative direction calculation unit 65 Target input unit 67 Display data generation unit 69 Display data output unit 71 Target calculation Part 73 Pedestal 75 Ray (light beam) 77 Floor surface 79 Base 81 Parietal surface 83 Puncture point 85 Marker 87 Target site 89 Target direction 90 Penetration depth 91 Axial direction 93 Tolerance , 94 ruler, 97 marker, 101 puncture needle orientation setting system, 102 CT scan device, 103 puncture needle holder, 104 puncture needle holder, 160 computer, 161 central processing unit (CPU), 163 memory (storage medium), 165 input/output interface 201 pedestal 203, 205 support member 207 needle insertion tube 209 screw body 211 main body 213 electronic component case 221 opening 253 needle holder XYZ cage coordinate system XYZ initial coordinates system, xyz CT coordinate system.

Claims (10)

a main body that detachably holds a puncture needle and can freely change its posture;
an orientation sensor installed in the main body, defining a retainer coordinate system that is a coordinate system fixed to the main body, and detecting the orientation of the main body or a change in the orientation;
a reset unit that receives a reset input;
The relative direction, which is the current direction of the axis of the puncture needle held by the main body, with reference to the initial coordinate system, which is the holder coordinate system when the reset unit receives the reset input, a relative direction calculator that calculates based on the detection data of the orientation sensor;
a target input unit that receives an input of a target direction, which is a target direction of the axis of the puncture needle, with reference to the initial coordinate system;
a display data generation unit that generates display data that displays a spatial relationship between the calculated relative direction and the target direction whose input is accepted;
and a display data output unit that outputs the generated display data. wherein the display data generation unit generates, as the display data, data representing the spatial relationship as a positional relationship on a display screen between the symbol corresponding to the relative direction and the symbol corresponding to the target direction. Item 1. The puncture needle holder according to Item 1. The main body is
a body defining a virtual pivot axis passing through the body;
a head adjacent to one end of the body along the pivot axis;
a leg adjacent to the other end of the body along the pivot axis;
The head part and the leg part are connected to each other by penetrating the body part, and the head part and the leg part are integrally rotatable about the rotation shaft. a connecting member supported by the part;
Each of the body portion, the head portion, and the leg portion has a holding hole for holding the puncture needle at the portion of the rotation shaft, and communicates from the holding hole in the radial direction of the rotation shaft. by forming a guide groove for guiding the puncture needle from the holding hole to the outside of the main body in the radial direction,
By setting the rotational positions of the head and the legs with respect to the body so that the guide grooves of the head and the legs are displaced from the positions overlapping the guide grooves of the body , the puncture needle is held in the holding holes of the body, the head, and the leg;
By setting the rotational positions of the head and the legs with respect to the body so that the guide grooves of the head and the legs overlap the guide grooves of the body, the puncture is performed. The needle is guided by the guide grooves overlapping each other, so that the needle can be taken out of the main body from the holding holes of the body, the head, and the leg. 3. The puncture needle holder according to 1 or 2. further comprising a cylindrical needle holder that retains the inserted puncture needle so that it can be inserted;
The puncture needle holder according to any one of claims 1 to 3, wherein the main body detachably holds the puncture needle by detachably holding the needle holder that holds the puncture needle. Based on the coordinate values of the puncture point on the body surface of the subject detected by the CT scan device and the target site in the body in the CT coordinate system, which is a coordinate system unique to the CT scan device, the puncture needle is detected. 2. A target calculation unit that calculates a target direction of an axis as a direction based on the CT coordinate system and inputs the calculated direction to the target input unit as the target direction. 5. The puncture needle holder according to any one of 4. The target input unit also receives input of an penetration depth, which is the depth at which the puncture needle should enter the subject's body,
5. The puncture needle holder according to any one of claims 1 to 4, wherein said display data generation unit generates, as said display data, data for displaying also said penetration depth whose input is accepted. 7. The puncture needle holder according to claim 6, further comprising a ruler installed on said main body and having dimension scales arranged along said puncture needle held by said main body. Based on the coordinate values of the puncture point on the body surface of the subject detected by the CT scan device and the target site in the body in the CT coordinate system, which is a coordinate system unique to the CT scan device, the puncture needle is detected. Calculate the target direction of the axis as a direction based on the CT coordinate system, input the calculated direction to the target input unit as the target direction, and calculate and calculate the approach depth. 8. The puncture needle holder according to claim 6 or 7, further comprising a target calculation unit that also inputs the penetration depth calculated to the target input unit. The puncture needle holder according to any one of claims 1 to 8, further comprising a display screen for displaying the display data output by the display data output unit. a CT scanner;
A puncture needle orientation system comprising: the puncture needle holder according to claim 9.

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